[Ellie_jo]

Just found out that the treatment I was approved for at 100% has changed since they checked and now the dr office says I am responsible for the whole thing. nope nope nope nope nope. Someone else is eating this one. If anyone fights me about it I might lose it entirely. COME AT ME BRO

[lilypup]

I love this story: My t (who is on Medicare herself) will not accept Medicare. Do ya love it?

[gina_re]

Originally Posted by Ellie_jo

Just found out that the treatment I was approved for at 100% has changed since they checked and now the dr office says I am responsible for the whole thing. nope nope nope nope nope. Someone else is eating this one. If anyone fights me about it I might lose it entirely. COME AT ME BRO

I do the same thing. I always call and make things right if I know for a fact that is wrong. Nope, I'm not paying that amount!! You got this!!

I hate insurance companies. Some of the crap they pull off is illegal or borderline illegal. Either way, it's immoral.

I remember a case from NH before Obamacare was enacted. There was a girl who had cancer, and she couldn't afford treatment because insurance refused to pay for it. (She was on her parents' insurance but got kicked off when she was 18... and no insurance company wanted to pay for her "pre-existing condition".) So, she had to work 2 part-time jobs in order to pay for her chemo. She ended up dying because she had to wait until she could afford treatment. I thought that was really messed up.

[Ocean Swimmer]

That is really messed up. I end up getting burned all of the time. The insurance companies suck. We pay high premiums.
There are no psychiatric Drs that will accept new patients. I pay cash. It is sick.

[Ellie_jo]

The mental health system is messed up from the start. Emergent hospitalization does little more than prevent someone from causing immediate harm (I guess that's the point) and follow up continuous management with therapy and psychiatrists is almost impossible gk

[Ellie_jo]

Impossible to get into and very limited. It's sad and unacceptable. Sorry for the break in posts; I accidentally hit the enter button too early 😌

It doesn't just happen in mental health. We ran into this problem recently when my husband's medical treatment claim was refused by insurance because it was done by the doctor's nurse practitioner rather than the doctor himself. (Apparently the logic that the nurse practitioner does nothing without the approval and oversight of the physician she works under made no difference.) Fortunately for us, the doctor's office acknowledged they were in error in not being sure the nurse practitioner was approved by the insurance company ahead of time and they ate the cost ($1400) -- that's a good doctor's office!

[Ellie_jo]

I'm so glad to hear that they were cool about that! I hope that happens more often. There are some good ones out there 😇

[pirilin]

I sold insurance. I know insurance. Insurance stinks!!!.

[st0psign]

insurance and pharmacies both grind my gears... big time. I feel ya, but it's probably best you do your best to keep your cool. it's the only way you get what you want, lashing out rarely produces positive outcomes.

[BeyondtheRainbow]

Keep complaining.....last fall I had my annual physical and then while later went in from a breast exam. I have had a hysterectomy so only get breast exams, not the full gyn exam. The NP apparently wasn't sure how to bill this so she billed it as annual exam which Medicare kicked back saying I could not have 2 of them. I called and after 2 times spending 30+ minutes on hold I got someone to listen to the need to bill for a breast exam and my right under Medicare to have one every other year. They wound up not even charging me my co-pay. Fine by me!

You might also check directly with the insurance company to find out why they didn't cover it when they said they would. OFTEN, I've discovered the doctor's office coded something wrong and that with a corrected claim insurance as able to cover it. It's all about the coding a good portion of the time. Insurance companies count on people not questioning their decisions. When you call and inquire and speak to someone other than the low man on the totem pole who has no power to make decisions, often things get reversed in your favor.